Childbirth Supporters

This article examines changes in maternity care and birth spaces that have occurred recently in the perinatal landscape of Greece. With caesarean sections over 50% since 2014, trends for a less medicalised approach prompted the creation of homelike rooms and spaces for water birth in private maternity hospital wards. New problems have emerged, but new possibilities have also been created. This investigation is based on the theoretical framework of the social production of space correlated with the concepts of contradiction and hybridity. For this study, I utilised bibliographical research on birth centres in Europe and Australia to comparatively evaluate the new spaces for nonmedicalized birth in Greece. I carried out site research on the recent developments in maternity spaces and practices using qualitative social research methods. I observed that the maternity landscape of Greece is fluid, and that a great number of contradictions and paradoxes are made evident through the material environment. The biomedical model appears to remain hegemonic, partly cancelling the aim for "homeyness", while marketing strategies coexist with women's demands. Nevertheless, despite such contradictions, women's choices appear to be on the increase, creating possibilities for the establishment of empowered maternal subjectivities.

This work is licensed under CC BY-SA License. It is important to know the experience of fathers who provide support during childbirth in terms of improving the childbirth results. This study describes the experiences of fathers who participate during their wives's childbirth in Türkiye. The research design is qualitative and descriptive, based on a phenomenological approach. Research data were collected through online in-depth interviews between January and February 2021. The sample comprised 12 fathers, reached by criterion sampling. The two data collection tools were the Individual Identification Form and the Semi-Structured Interview Form. Content analysis of the research data was conducted using Maxqda. Four themes emerged to describe the father's birthing experiences: "prenatal preparation", "fathers' birthing support", "emotions experienced during the birthing", and "fathers' views of the birth". The fathers experienced many contrary emotions during the birth process. Fathers have a positive experience from participating during their partner's birthing process due to the midwife's support. Fathers who want to support their partners during birth should be informed about the importance of participating in prenatal courses.

Doğumdaki fizyolojik sürecin anlayamadığımız bazı yönleri olsa da kadınlar üzerinde doğum ünitesi koşullarının oldukça önemli bir etkisi vardır. Bu araştırmanın amacı doğum deneyimlemiş kadınların doğum ünitesi koşulları ve doğum memnuniyetini etkileyen ideal doğum ünitesi tasarımı üzerine düşüncelerinin incelemesidir. Gereç ve Yöntem: Bu çalışma, normal doğum deneyimi olan 232 kadın ile gerçekleştirilen kesitsel bir araştırmadır. Çalışmada araştırmacılar tarafından geliştirilen bir anket form kullanılmış, bulguların yorumlanmasında tanımlayıcı istatistik tekniklerden yararlanılmıştır. Bulgular: Çalışmamızda kadınların çoğu tarafından doğum ünitesinin özel girişi olması (%62,9), tek kişilik doğum odası (%96,6), doğum ünitesinin ses düzeyi (%89,6), mahremiyetin korunması (%100,0), şahsi tuvalet (%92,2) ve ılık duş alma imkânı (%74,1) ideal doğum ünitesinden beklenen özellikler olarak bildirilmiştir. Sonuç: Çalışmanın sonucunda doğum ünitesinin özel girişi olması, tek kişilik doğum odası, doğum ünitesinin ses düzeyi, mahremiyetin korunması, şahsi tuvalet ve ılık duş alma imkânının kadınların doğum memnuniyetlerini etkileyeceğini düşündükleri belirlenmiştir.

To explore inhibiting and facilitating design factors influencing childbirth supporters' experiences. Birthing women benefit from the continuous, cooperative presence of supporters. However, little research has investigated how birth room design facilitates or inhibits supporters' role navigation. We conducted an exploratory video ethnographic single case study of childbirth supporters' experiences, within an Australian hospital birth environment. Video, field notes, and video-cued reflexive interviews with the woman, her midwives, and supporters were thematically analyzed using ethnographic/symbolic interactionist perspectives to frame supporters' understandings. Findings suggest supporters' experiences are complex, made more complicated by sparse understanding or accommodation of their needs in the built environment. Supporters' presence and roles are not facilitated by the physical space; they experience "an unbelonging paradox" of being needed, ...

INTRODUCTION This study aimed to explore both mothers' and fathers' lived experiences of the birth environment. Objectives were set to explore how the physical, psychosocial, spiritual and cultural environment during labor, influence the parents' birth experience, and to delve into the similarities and differences between mothers' and fathers' views and experiences of the birth environment. METHODS The study adopted an interpretive phenomenological research design. A purposive homogenous sample of seven couples was recruited from the main local public hospital in Malta. Data were collected using one-time, face-to-face, semi-structured interviews with each couple. The birth territory theory by Fahy guided this study and interpretive phenomenological analysis was used to analyze, interpret and elicit the meanings that participants attributed to their experiences of the birth environment. RESULTS Three super-ordinate themes emerged from the data: 'The home-hospital gap', 'Midwifery care' and 'Movement in labor'. A conflict between the comfort of home and home-like aesthetics, and the reassuring, but foreign, clinical environment and medical equipment, was felt by mothers and fathers. The midwife was a fundamental part of the birth environment for the parents, taking precedence over the physical environment. Movement in labor was important to mothers while fathers became more involved when mothers were mobile during labor. The birth environment consisted of facilitating and impeding factors to movement, which made an impact on the parents' experiences. CONCLUSIONS Mothers and fathers experienced the birth environment from different perspectives. However, they have indicated similar needs and desires from the birth environment, creating a shared experience.

Background Randomized controlled trials (RCTs), especially multicentric, with complex interventions are methodically challenging. Careful planning under everyday conditions in compliance with the relevant international quality standard (Good Clinical Practice [GCP] guideline) is crucial. Specific challenges exist for RCTs conducted in delivery rooms due to various factors that cannot be planned beforehand. Few published RCTs report challenges and problems in implementing complex interventions in maternity wards. In Germany as well as in other countries, midwives and obstetricians have frequently little experience as investigators in clinical trials. Methods The aim is to describe the key methodological and organizational challenges in conducting a multicenter study in maternity wards and the solution strategies applied to them. In particular, project-related and process-oriented challenges for hospital staff are considered. The exemplarily presented randomized controlled trial “BE-U...

Background: Many women experience giving birth as a negative or even as a traumatic event. Birth space and its occupants are fundamentally interconnected with negative and traumatic experiences, highlighting the importance of the social space of birth.

Aim: To explore experiences of women who have had a negative or traumatic birth to identify the value, sense and meaning they assign to the social space of birth.

Methods: A feminist standpoint theory guided the research. Secondary discourse analysis of 51 qualitative data sets/transcripts from Dutch and Czech Republic postpartum women and 551 free-text responses of the Babies Born Better survey from women in the United Kingdom, Netherlands, Belgium, Germany, Austria, Spain, and the Czech Republic.

Findings: Three themes and associated sub-themes emerged: 1. The institutional dimension of social space related to staff-imposed boundaries, rules and regulations surrounding childbirth, and a clinical atmosphere. 2. The relational dimension of social space related to negative women-healthcare provider interactions and relationships, including notions of dominance, power, authority, and control. 3. The personal dimension of social space related to how women internalised and were affected by the negative social dimensions including feelings of faith misplaced, feeling disconnected and disembodied, and scenes of horror.

Discussion/Conclusion: The findings suggest that improving the quality of the social space of birth may promote better birth experiences for women.  The institutional, relational, and personal dimensions of the social space of birth are key in the planning, organisation, and provision of maternity care.

Background: When transfer in labour takes place from a birth centre to a tertiary maternity hospital the woman, her partner and the midwife (the triad) are involved, representing three different perspectives. The purpose of this paper is to explore the integration of these intrapartum transfer experiences for the birth triad. Methods: Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of Western Australian women, their partners and midwives across the birth journey. Forty-five interviews were conducted. Findings: Findings revealed that experiences of intrapartum transfer were unique to each member of the triad (woman, partner and midwife) and yet there were also shared experiences. All three had three themes in common: 'The same journey through three different lenses'; 'In my own world' and 'Talking about the birth'. The woman and partner shared two themes: 'Lost birth dream' and 'Grateful to return to a familiar environment'. The woman and midwife both had: 'Gratitude for continuity of care model' and the partner and midwife both found they were: 'Struggling to adapt to a changing care model' and their 'Inside knowledge was not appreciated'. Conclusion: Insight into the unique integrated experiences during a birth centre intrapartum transfer can inform midwives, empowering them to better support parents through antenatal education before and by offering discussion about the birth and transfer after. Translation of findings to practice also reinforces how midwives can support their colleagues by recognising the accompanying midwife's role and knowledge of the woman.

The birthing room is a major workplace for midwives but how it influences them in practice is not enough investigated. Purpose: This study aimed to explore midwives´ experiences of how the birthing room affects them in their work to promote a normal physiological birth. Methods: A phenomenological reflective lifeworld research approach was used and included individual interviews with 15 midwives working at four different hospitals in western Sweden, and of which two also assisted at homebirths. The analysis focused on the meanings of the study phenomenon. Results: A birthing room can by its design either support a normal physiological birth or support a risk approach to childbirth. Four opposing constituents complete the essential meaning of the birthing rooms, and to which the midwives need to relate in their roles as guardians for normal birth: i) a private or a public room; ii) a home-like or hospital-like room; iii) a room promoting activity or passivity; iv) a room promoting the midwife´s presence or absence. Conclusions: The birthing room mirrors a pathogenic-oriented care approach. A presupposition for the work to keep the birth bubble intact is to protect the mother from disturbing elements both inside and outside the room.

Background: When transfer in labour takes place from a birth centre to a tertiary maternity hospital the woman, her partner and the midwife (the triad) are involved, representing three different perspectives. The purpose of this paper is to explore the integration of these intrapartum transfer experiences for the birth triad. Methods: Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of Western Australian women, their partners and midwives across the birth journey. Forty-five interviews were conducted. Findings: Findings revealed that experiences of intrapartum transfer were unique to each member of the triad (woman, partner and midwife) and yet there were also shared experiences. All three had three themes in common: 'The same journey through three different lenses'; 'In my own world' and 'Talking about the birth'. The woman and partner shared two themes: 'Lost birth dream' and 'Grateful to return to a familiar environment'. The woman and midwife both had: 'Gratitude for continuity of care model' and the partner and midwife both found they were: 'Struggling to adapt to a changing care model' and their 'Inside knowledge was not appreciated'. Insight into the unique integrated experiences during a birth centre intrapartum transfer can inform midwives, empowering them to better support parents through antenatal education before and by offering discussion about the birth and transfer after. Translation of findings to practice also reinforces how midwives can support their colleagues by recognising the accompanying midwife's role and knowledge of the woman.

Objectives, Purpose, or Aim: This article investigates whether the physical environment in which childbirth occurs impacts the intrapartum intervention rates and how this might happen. The study explores the spatial physical characteristics that can support the design of spaces to promote the health and well-being of women, their supporters, and maternity care professionals. Background: Medical interventions during childbirth have consequences for the health of women and babies in the immediate and long term. The increase in interventions is multifactorial and may be influenced by the model of care adopted, the relationships between caregivers and the organizational culture, which is made up of many factors, including the built environment. In the field of birth architecture research, there is a gap in the description of the physical characteristics of birth environments that impact users’ health. Method: A scoping review on the topic was performed to understand the direct and indir...

Objectives, Purpose, or Aim: This article investigates whether the physical environment in which childbirth occurs impacts the intrapartum intervention rates and how this might happen. The study explores the spatial physical characteristics that can support the design of spaces to promote the health and well-being of women, their supporters, and maternity care professionals. Background: Medical interventions during childbirth have consequences for the health of women and babies in the immediate and long term. The increase in interventions is multifactorial and may be influenced by the model of care adopted, the relationships between caregivers and the organizational culture, which is made up of many factors, including the built environment. In the field of birth architecture research, there is a gap in the description of the physical characteristics of birth environments that impact users’ health. Method: A scoping review on the topic was performed to understand the direct and indir...

Objective: this study examined images of birth rooms in developed countries to analyse the messages and visual discourse being communicated through images.
Design: a small qualitative study using Kress and van Leeuwen's (2006) social semiotic theoretical fra- mework for image analysis, a form of discourse analysis.
Setting/participants: forty images of birth rooms were collected in 2013 from Google Images, Flickr, Wikimedia Commons and midwifery colleagues. The images were from obstetric units, alongside and freestanding midwifery units located in developed countries (Australia, Canada, Europe, New Zealand, United Kingdom and the United States of America).
Main findings: findings demonstrated three kinds of birth room images; the technological, the ‘homelike’, and the hybrid domesticated birth room. The most dominant was the technological birth room, with a focus on the labour bed and medical equipment. The visual messages from images of the technological birth room reinforce the notion that the bed is the most appropriate place to give birth and the use of medical equipment is intrinsically involved in the birth process. Childbirth is thus construed as risky/dangerous.
Key conclusions and implications for practice: as images on the Internet inform and persuade society about stereotypical behaviours, the trends of our time and sociocultural norms, it is important to recognise images of the technological birth room on the Internet may be influential in dictating women's attitudes, choices and behaviour, before they enter the birth room.

In this study, the use of hypnotherapy in high-risk pregnancy is explored from an ecological systems perspective through two case studies. Each case study is described in detail. They explore the experiences of two women during their pregnancy and giving birth, with specific reference to the pregnancy risks and their use of hypnotherapy. The study provides the reader with an in-depth understanding of the use of hypnotherapy before, during and after birth. KEY TERMS Prenatal psychology; perinatal psychology; preterm labour; caesarean birth; high-risk pregnancy; hypnotherapy; HypnoBirthing®; hypnosis; case study; ecological systems designing hypnotherapeutic interventions aimed at reducing the risk of complications during pregnancy. Pregnancy is a normal life-developmental experience, which involves biological, psychological and social changes. These changes can be stressful. When a pregnancy is complicated, and carries higher risks than normal for the mother or foetus, stress is increased and can have detrimental effects. Psychology, in recent years, has recognised its role in the psychological health of the unborn and infant, and the field of prenatal and perinatal psychology has developed in this domain. Hypnosis has historically been recognised as an effective aid to pregnancy, especially for its anaesthetic or analgesic effects during childbirth. Research in hypnosis has also advanced in its understanding of the mind-body connection and, increasingly, there is understanding that hypnosis facilitates mind-body communication (and healing). This understanding has contributed to using hypnosis for the treatment of conditions traditionally considered to be medical. The HypnoBirthing® approach therefore, shows potential for extending medical care beyond the traditional use of anaesthetic or analgesic for childbirth. It could be used to address the psychological and biological aspects of pregnancy that are considered to be high risk. The literature study explores these concepts in greater detail, providing both an explanation of the development and use of hypnosis in pregnancy and a rationale for the therapeutic use of hypnosis to address aspects of high-risk pregnancy. hypnosis. According to James et al. (2000), Hull was also a strong influence on the young Milton Erickson, who became known worldwide for his unique permissive approach to hypnosis, now simply referred to as Ericksonian hypnosis. In contrast to Erickson's permissive, non-directive approach, more directive approaches also developed, such as that of George Estabrook and Dave Elman (1964). 2.3.3 The myths of hypnosis According to Yapko (2003), there are many myths and misconceptions about the nature of hypnosis and how it is practiced, and these can interfere greatly with the therapeutic process. research. Participants are not remunerated in any manner for participating in the research. Indemnity Ultimately each research participant is the expert of their own body and mind, and has to take responsibility to do what is in their own best interest. By signing this consent form, the research participants agrees not to hold the researcher or university liable for any damages that may result, directly or indirectly, for participating in this research study.

Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. in particular, the setting in which childbirth takes place is highly influential. The physiological processes of women's labor and birth are enhanced in optimal ("salutogenic," or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of italian birth places incorporate principles of healthy settings. The "Margherita" Birth centre in Florence and the Maternity Home "il Nido" in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. comparisons between cases with a standard hospital labor ward layout were performed. cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. in particular, the setting in which childbirth takes place is highly influential. The physiological processes of women's labor and birth are enhanced in optimal ("salutogenic," or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of italian birth places incorporate principles of healthy settings. The "Margherita" Birth centre in Florence and the Maternity Home "il Nido" in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. comparisons between cases with a standard hospital labor ward layout were performed. cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. in particular, the setting in which childbirth takes place is highly influential. The physiological processes of women's labor and birth are enhanced in optimal ("salutogenic," or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of italian birth places incorporate principles of healthy settings. The "Margherita" Birth centre in Florence and the Maternity Home "il Nido" in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. comparisons between cases with a standard hospital labor ward layout were performed. cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. in particular, the setting in which childbirth takes place is highly influential. The physiological processes of women's labor and birth are enhanced in optimal ("salutogenic," or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of italian birth places incorporate principles of healthy settings. The "Margherita" Birth centre in Florence and the Maternity Home "il Nido" in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. comparisons between cases with a standard hospital labor ward layout were performed. cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. in particular, the setting in which childbirth takes place is highly influential. The physiological processes of women's labor and birth are enhanced in optimal ("salutogenic," or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of italian birth places incorporate principles of healthy settings. The "Margherita" Birth centre in Florence and the Maternity Home "il Nido" in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. comparisons between cases with a standard hospital labor ward layout were performed. cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

Background
It is accepted that the physical environment of healthcare influences the perceptions and experiences of patients and staff. Research has explored how birth unit design influences the experiences of women and midwives during childbirth. However, although there is evidence that cooperative supporters are beneficial to labouring women, and that women desire such support, little attention has been paid to the impact of physical design on the experiences of a woman's chosen childbirth supporter. This thesis describes how the physical environment influences the behaviour, experiences and role navigation of birth supporters.
Aim
To gain an understanding of how physical birth environment design accommodates women’s supporters and facilitates their support roles.
Study Design
This childbirth supporter study presented in this thesis, is a research substudy of a larger Birth Unit Design (BUD) research project. Ethics approval was obtained for the BUD video-ethnographic study where six consenting women and their 11 supporters were filmed during labour at two different Australian hospitals (February/March 2012). The
‘childbirth supporter study’ (CSS) presented here is a single-case study design that was selected from the larger cohort of participants from the BUD study. One woman, her four supporters and three midwives provided the foundation for the ‘childbirth supporter study’ described in this thesis. Video footage and video-cued interviews with all participants and observational field notes provided data for analysis. Three-phase analysis cycle for both text and video included: descriptive, interpretive and selective
coding (using an approach informed by Saldaña, 2013). Phase one, the descriptive coding cycle, consisted of identifying what would be filmed, viewing the video, reading the transcription text and interview field notes and becoming familiar with the data. Phase two, the interpretive/pattern coding cycle, consisted of condensing the data so that themes could begin to be identified, such as by selecting exemplar still images from the video footage. The third phase, the selective/codeweaving stage, consisted of data reconstruction and synthesis, to facilitate interpretation of the evidence into thematic findings. The ‘AEIOU’ framework (an analysis approach informed by Wasson, 2000) was utilised for the video data during the third phase of analysis. An extended, reflective cross-validation inquiry of the thematic findings, using the Birth Unit Design Spatial Evaluation Tool (BUDSET) as both criterion and building block, provided translation of the findings into practice.
Findings
The physical environments of typical birth units do not appropriately meet the needs of supporters, who may feel unsure of their role, behaviour or positioning, thus limiting the potential benefits of their support role. Key themes are: ‘Unbelonging Paradox’, ‘Role Navigation’ and ‘Supporting the Supporter’. Findings are supported by illustrative video footage stills and verbatim quotes. Viewing supporters as both individuals and part of a team dyad is the basis for the design recommendations. Examples of some of
the recommendations are: spaces for both privacy and togetherness; informational support zones; transition space; positive distracters; easy access food, drink and toilet facilities; and the ability to personalise and adjust the space to increase the perception of agency.
Implications and Relevance to Practice
Knowing how the design of birth units can best accommodate the needs of women’s supporters may facilitate optimal birth experiences for women and increase opportunities for safe, satisfying birth. Designers and healthcare managers may benefit from understanding the birth environment’s influence on supporter’s behaviours.